- Humana (Albany, NY)
- …their medical background, experience, and judgement to make determinations whether requested services , requested level of care, and/or requested site of service ... and clinical documentation, dispute, grievance, and appeals processes, and outpatient services and equipment, within their scope. The Medical Director may speak… more
- Humana (Albany, NY)
- …uses their medical background, experience, and judgement to make determinations whether requested services , level of care, and/or site of service should be ... hospital-based clinical scenarios, and providing expert decisioning on the requested services . They will have regular discussions with external providers by phone… more
- Humana (Albany, NY)
- …their medical background, experience, and judgement to make determinations whether requested services , requested level of care, and/or requested site of service ... The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with… more
- Bump Boxes (Rochester, NY)
- Locally established Rochester, NY Durable Medical Equipment company offers quality service , quality equipment and great follow up care to its customers. We provide ... Insurance verification + Prior Authorization + Billing experience - Medicare, Medicaid, or Managed Care + Medical Office + Healthcare background + CPAP and Oxygen… more
- Canon USA & Affiliates (New York, NY)
- …Business Process Services , Inc. offers a comprehensive portfolio of managed services and technology across information and document management, business ... skills, as well as those pursuing a career in managed business process services for the first...; and follow us on Twitter @CanonBPO. **Responsibilities** **Customer Service :** + Provides support to end users on a… more
- Meta (Albany, NY)
- …to work closely and effectively with a variety of cross functional teams, managed service providers, and third-party vendor partners 2. Escalation Management: ... **Summary:** The broader Edge Network Services (ENS) organization designs, builds(deploys), and supports(operates) a...third parties such as hardware, colocation, telecom carrier, and managed service partners 12. Project Leadership: Lead… more
- Humana (Albany, NY)
- …skills to make an impact** **Key Responsibilities:** + Lead and provide direction for our Managed Service Provider (MSP) + Lead Managed Service Provider ... Management + Participate and develop client relationships within Operations, Business partners, Managed Service Providers and Cloud Providers + Work with… more
- Humana (Albany, NY)
- …providing clinical support for internal stakeholders. Utilizes broad understanding of managed care and PBM knowledge to develop, and/or implement strategies and ... - Medicaid health plan. The individual leverages a broad understanding of managed care and pharmacy benefit management (PBM) to develop and implement strategies… more
- Securitas Security Services USA, Inc. (New York, NY)
- …lead daily security operations and ensure a safe, compliant, and well- managed environment across campus facilities. This role requires strong leadership, exceptional ... communication skills, and the ability to effectively oversee security personnel. The ideal candidate will be proactive, detail-oriented, and capable of responding swiftly and effectively to emergencies, safety concerns, and operational needs. **Key… more
- Catholic Health Services (Roslyn, NY)
- …Maintains knowledge of requirements by third party payers, regulatory agencies, and managed care entities concerning levels of care, continuity of benefits and ... medical necessity guidelines. At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a… more